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Published on: April 18, 2011
Pelvic fractures as a marker of injury severity in trauma patients
Roberto de Moraes Cordts Filho1, José Gustavo Parreira, Jaqueline A Giannini Perlingeiro
1Department of Surgery, Faculdade de Ciência Médicas da Santa Casa de São Paulo, Emergency Service, Santa Casa de Misericordia de Sao Paulo.
Insights
Pelvic fractures in blunt trauma victims indicate more severe injuries and poorer outcomes. This study highlights pelvic fractures as a critical indicator of injury severity and prognosis in trauma patients.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Orthopedic Trauma
Background:
- Blunt trauma is a leading cause of mortality and morbidity.
- Assessing injury severity and predicting prognosis are crucial for effective trauma care.
Purpose of the Study:
- To determine if pelvic fractures correlate with increased injury severity and worse outcomes in blunt trauma patients.
Main Methods:
- Retrospective analysis of 2019 blunt trauma victims (June 2008-March 2009).
- Comparison of patients with pelvic fractures (Group I) versus those without (Group II).
- Statistical analysis using Student t test, Fisher's exact test, and chi-square test (p <0.05 significant).
Main Results:
- Pelvic fractures (2.1%) were associated with lower blood pressure, higher heart rate, and lower Glasgow Coma Scale.
- Group I had higher Abbreviated Injury Scale (AIS) scores, Injury Severity Score (ISS), and more frequent head, spinal, thoracic, and abdominal injuries.
- Complications like ARDS, shock, coagulopathy, renal failure, and death were significantly higher in Group I (e.g., 28% vs. 2% mortality).
Conclusions:
- Pelvic fractures serve as a significant marker for increased injury severity in blunt trauma.
- The presence of a pelvic fracture is indicative of a worse prognosis for trauma patients.
Objective:
To assess whether the presence of a pelvic fracture is associated with greater severity and worse prognosis in victims of blunt trauma.
Methods:
A retrospective analysis of protocols and records of victims of blunt trauma admitted from June 2008 to March 2009 was separated into two groups: those with pelvic fracture (Group I) and those without it (Group II). Data were collected from pre-hospital admission rates of trauma, laboratory tests, diagnosed lesions, treatment and outcome. We used the Student t test, Fisher's exact test and chi-square test for statistical analysis, considering p <0.05 as significant.
Results:
During the study period, 2019 individuals had multiple trauma protocols completed, of which 43 (2.1%) had pelvic fractures. Patients in Group I had significantly lower average blood pressure, higher mean heart rate, lower mean Glasgow Coma Scale, the highest average AIS in the segments head, chest, abdomen and extremities, as well as higher mean ISS and lower mean TRISS and RTS on admission. Group I more frequently presented with traumatic subarachnoid hemorrhage (7% vs. 1.6%), spinal cord injury (9% vs. 1%), thoracic and abdominal injuries, as well as need for laparotomy (21% vs. 1 %), chest drainage (32% vs. 2%) and damage control (9% vs. 0%). Complications were more frequent in group I: ARDS (9% vs. 0%), persistent shock (30% vs. 1%), coagulopathy (23% vs. 1%), acute renal failure (21% vs. 0%) and death (28% vs. 2%).
Conclusion:
The presence of a pelvic fracture is a marker of greater severity and worse prognosis in victims of blunt trauma.
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